POOL-000602-2016 TOWN OF QUEENSBURY
at 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: POOL-000602-2016 Date Issued:
This is to certify that work requested to be done as shown by Permit Number POOL-000602-2016
has been completed.
Tax Map Number: 290.6-1-54
Location: 8 STONEHURST DR
Owner: RICHARD CIPPERLY,Paula Cipperly
Applicant: RICHARD CIPPERLY
This structure may be occupied as a: Inground Pool
By Order of Town Board
TOWN OF QUEENSSB /f
BURY
Issuance of this Certificate of Compliance DOES NOT relieve the �. (/ �,J ke
property owner of the responsibility for compliance with Site Plan, �(���(((JJJJGGG���111��� v
Variance,or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
qW Community Development-Building& Codes (518)761-8256
BUILDING PERMIT
Permit Number: POOL-000602-2016
Tax Map No: 290.6-1-54
Permission is hereby granted to: Concord Pools Ltd.
For property located at: 8 STONEHURST DR
In the Town of Queensbury,to construct or place at the above location in accordance with application together
with plot plans and other information hereto filed and approved and in compliance with the NYS Uniform
Building Codes and the Queensbury Zoning Ordinance
Tvce of Construction
Owner Name: RICHARD CIPPERLY Swimming Pool $0.00
Owner Address: 8 Stonehurst DR Total Value $0.00
Queensbury,NY 12804
Contractor or Builders Name/Address Electrical Inspection Agency
Concord Pools Ltd.
60 BIG BOOM RD
Queensbury,NY 12804
Plans&Specifications
Inground Pool
$75.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday,September 19,2017
(If a longer period is required,an application for an extension most be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town oury Mo d y lertf6er 19,2016
SIGNED BY: \/ for the Town of Queensbury.
Director of Building&Code Enforcement
Town of Queensbury Building & Codes Office Use Onlv
Received:
SWIMMING POOL PERMIT APPLICATION Tax Map ID:
A permit must be obtained before beginning construction Permit No.: %DL.- (.oz- X110
Permit Fee: $ '� 1Ywoil3 1006
Site Plan/Variance No.:
1. Date:
2. Tax Map ID: X90 6
3. Pool Location Address: Syv.r/4vtz?, ! 11,V-e-
4. Zoning Classification: ��
5. Site Plan Review,Variance or Subdivision Approvals(list)
41
�llv� , n
6. Property Owner: � � '/'���i Phone: -79 33�YS'
Mailing Address: ��a�+>�✓err �'
City: //iw� �`✓�
7. Contractor's Name: Lilt d� ��jo� Phone: 7f11-oPs,0
Mailing Address: 60 6�y fSdow
City: ' dv
8. Contact Person for Building&Code Compliance: Phone793 2&-VS—
ABOVE-GROUND OR INGROUND?
SIZE OF POOL:
MANUFACTURER: �✓ d<� ��J SEP 1)8 201
MATERIALS USED IN CONSTRUCTION(CHECK ALL THAT APPLY):
Steel/Vinyl Fiberglass /X Gunite Poured Concrete Other
Declaration: I acknowledge no construction activities shall be commenced prior to issuance of a valid permit. I certify that the application,
plans, and supporting materials are a true and complete statement/description of the work proposed, that all work will be performed in
accordance with the NY State Building Codes, local building laws and ordinances, and in conformance with local zoning regulations. I
acknowledge that I have read the application & plot plan requirements and I or my agents will obtain a certificate of occupancy before use
of the pool.
Print Name: ✓ /�1i��4 Lf�/Pi1</ `/ C
Signature: ii- O� � Date
Na /
Town of Queensbury Building&Codes Swimming Pool Permit 518-761-8256
P-ERMT- PLAN Richard and Paula Cipperly
I HAVE PERSONALLY klEASURED THE DISTANCE 8 Stonehurst Drive
FROM THE PROPERTY LINES TO THE Queensbury N
PR �SIRUCeUS)OR
/6 Tax Map ID 290.6-1-54
SIGN /I
ATE
�lenmur �rIJ�
TOWN OF QUEENSBURY C,r
BUILDINC DEr,RTk4ENT
Based on our Ilmit^d ex2rhz5on-compliance
vith our common!:, r_nfrued as
dicatIn the pians anc s.eOrcations are in
f II compliance with the wilding Codes of
N w York State.
TOWN OF QUEENSBURY
WILDING & COD
D
eviewed By T. / \
te: I f\ `P, = .
tion Home Qwner
Plea71
se ssure you are-familiar with the ` 1
Pool En 6sre-requirementsspecific to
Your po6 We will be ha 1 3
what R uirements oU it to explain I
meet r Appendix will have to �
ppendix G Of the P- Open Porch
New Yo State Residential Code. 't '=:3�` G- Garage
A- 2008 Addition
PL- Pool
290.6-1-54 POOL-000602-2016 1"=40'
Cipperly, Richard 9/2016
8 Stonehurst Drive
Inground Pool
Jul. 20. 2011) 2:45.tyw IA No. 9154 P. 2
MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
W,r 4 that the electrical wiring to the electrical equipment listed below has been examined and is approved as
being in accord with the National Electrical Code, applicable governmental, utility and Agency rules in effect on the date
noted below and is issued subject to the following conditions.
Owner. Ciparly Date:
07/12/2017
Occupant: Inground Pool Location
8 Stonehurst Dr.
Occupancy-'Swimming Pool Queensbury, Warren Co. NY
Applicant
John T.Wheeler
2594 State Hwy 29
Johnstown, NY 12095
Joseph A.Holmes
No-
- -
- - - - - - 14001513577_OEL_. - - - - -
Equipment:
1 -Receptacle; 2- Low Voltage FixtuFft 1 'gurney, KHhg &ContPdls;-1 Pump; T-' Chlorinator; 1 - Easy Touch
Panel
This certificate applies to the electrical wiring to the electoml equipment listed immediately null and void. Trus cartificate apvles only to the use,Occupancy and
above and the instwistion unspotted as Of the above noted date based on a visual ownership as lr6eatad herein. Upon a change in the use,occupancy or owmership
inspection. No warranty is expressed osimplied as to the mechanical safety effi- of the property Indicated above,this certificate shall be immedlatety null and void.
ciency or fitness of the equipment for any particular purpose. This cenlricata Shall In the event that this COMIC=becomes Invalid OaSed upon the above conditions•
be valld for a period of one year from the above road date. Should the electrinsl this certificate may be favalidwed upon reinspection by Middle Department
system to which this conificate applies be abered in any way including but not fimit• Inspection Agancy.Inc. An application for inspection must be Submitted to Middle
ed to,the introduction of emitional elecbiow equipment andlor the replacement of Department InspeCaon Agency, Inc.to Initials the inspectlon and revalidation
any of the components installed as of the above noted date.this certificate shall be process. A lee Will be charged for tnls Service.
�ODL- HOZ. ^ Zol b
JUL 21 2017 t
I TOWN OF QUEENSBURY f
BUILDING & CODES